Photo: Tomsickova Tatyana (Shutterstock)
You hear your child cough on the way downstairs for breakfast, and the mental calculations start: Was that a one-off cough or a legit symptom? Should I take her temperature? Should she go to school or stay home, just in case? Meanwhile your kid doesn’t seem at all like she’s in a medical emergency; she just wants her waffles. Maybe you’re overreacting to the latest virus symptoms, or maybe you’re underreacting—it’s the internal debate every parent has these days.
For nearly three years, we have been on high alert for COVID-19 signs, and many parents have found it hard to temper their panic through this season of many viruses. We talked to Kelly Fradin, director of pediatrics at Atria Institute and author of Advanced Parenting: Advice for Helping Kids Through Diagnoses, Differences, and Mental Health Challenges for some tips on recalibrating our responses to childhood virus symptoms in the COVID era.
“After two respiratory seasons of social distancing and masking, parents got out of the habit of supporting their children through the viruses and bacteria constantly circulating,” Fradin said. “Additionally, we became habituated to looking at every runny nose as a potential harbinger of impending COVID that might be a risk to our family’s or our children’s teachers or caregivers.”
Besides our radar being more sensitive to detecting (and reacting to) virus symptoms, many children are playing catch up on medical and developmental services that took a back seat during the early years of the pandemic, Fradin said. Some children may have long COVID or mental health challenges related to the pandemic.
“All to say there are many legitimate and tangible reasons parents may feel more anxious now about their children’s health, although for the most part, the health threats facing our children are not more common than they were before the pandemic,” she said.
I don’t know how many times I’ve heard it (or said it) this winter. In my own family, we’ve navigated strep, Flu A, Flu B, and coronavirus since December, along with whatever random sniffles they don’t test for. It feels like a season of neverending sickness, but maybe it’s not necessarily cause for panic.
Pediatrician Krupa Playforth shared a reality check for anxious parents on her website: “Believe it or not, in the first year of school, it is normal to have 6-8 respiratory infections (colds, coughs), 1-2 tummy bugs, and a few other scattered viral infections such as [hand, foot and mouth disease] or roseola,” Krupa wrote.
All those viruses add up when you watch them filter through a household with a mix of elementary age children and adults. No wonder it seems like the illnesses never ends.
“We had a very early flu season, and we have had a lot of RSV, metapneumovirus, adenovirus, and strep circulating in NYC. Children and adults have continued to get COVID but the frequency of hospitalization has decreased,” Fradin said. “It’s a bit hard to say whether the number of cases of these infections are increased from winters before the pandemic, because we’ve also changed our behavior to take viruses more seriously and test more frequently.”
Rules of thumb for responding to virus symptoms
Should your child stay home from school? Keep your child home if that have a fever or symptoms that would interfere with their ability to learn, like major congestion or cough, Fradin said. Also keep kids home if they have signs of pinkeye, vomiting, or diarrhea. Keeping a child home from school is of course about helping them heal from illness, but it’s also an important way to prevent spreading illness to the community.Should you test your child for COVID? If they have symptoms of COVID like fever, cough, loss of taste or smell, congestion, sore throat, stomach upset, or headache, test for COVID, Fradin said. If they were exposed to someone with COVID but have no symptoms, wait five days and test.Should you call the pediatrician or nurse line? “Generally speaking, I always want parents to call or go to the emergency room if they are concerned about their child’s breathing or hydration status,” Fraden said. “For fever, I suggest seeing the pediatrician for evaluation between day three and day five, depending on the duration and severity of the symptoms. For babies under 2 months of age, they should call immediately with fever.”Should you go to urgent care? “The use of urgent care depends on the services available through the medical home,” said Fraden, referring to the child’s regular pediatrician. “When possible, using the same pediatrician for all care can help organize your family’s care and spot trends early. If your pediatrician isn’t available, consider who staffs your local urgent care and don’t hesitate to confirm they are qualified and experienced caring for children.”
Managing your health anxiety
In our particularly viral season, I adopted a mantra of, “I choose to heal.” I am not a doctor, but I am a parent with severe anxiety about the health of my two small children. When I start to panic about a cough or fever, I remember the point of our inner alert system is to keep our families safe. What keeps us safe is following the rules of thumb listed above, treating symptoms, and calling a professional when I’m uncertain.
“I’ve suggested to many parents a mantra of, ‘I’m tracking symptoms to keep others safe,’” Fradin said. “Parents have taken on a contact-tracing responsibility. Since children can have a runny nose for 4-6 weeks after a virus, often it’s hard to tell if it’s the residual symptoms or something new. I encourage parents to use testing as a tool when they are uncertain, to help them be kind to those around their child.”